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Myofibroblast Phenotype and Reversibility of Fibrosis in Patients With End-Stage Heart Failure Sex Differences in Cardiovascular Pathophysiology: Why Women Are Overrepresented in Heart Failure With Preserved Ejection Fraction Titration of Medical Therapy for Heart Failure With Reduced Ejection Fraction Prevalence and clinical implications of valvular calcification on coronary computed tomography angiography DAPT, Our Genome and Clopidogrel Intravascular Ultrasound to Guide Left Main Stem Intervention: A Sub-Study of the NOBLE Trial Two-Year Outcomes with a Magnetically Levitated Cardiac Pump in Heart Failure Feasibility of Coronary Access and Aortic Valve Reintervention in Low-Risk TAVR Patients From ACE Inhibitors/ARBs to ARNIs in Coronary Artery Disease and Heart Failure (Part 2/5) Intravascular ultrasound-guided vs angiography-guided drug-eluting stent implantation in complex coronary lesions: Meta-analysis of randomized trials

Clinical Trial2017 Apr 18;69(15):1952-1967.

JOURNAL:J Am Coll Cardiol. Article Link

The Aging Cardiovascular System: Understanding It at the Cellular and Clinical Levels

Paneni F, Diaz Cañestro C, Camici GG et al. Keywords: arterial stiffness; endothelium; epigenetics; stem cells

ABSTRACT


Cardiovascular disease (CVD) presents a great burden for elderly patients, their caregivers, and health systems. Structural and functional alterations of vessels accumulate throughout life, culminating in increased risk of developing CVD. The growing elderly population worldwide highlights the need to understand how aging promotes CVD in order to develop new strategies to confront this challenge. This review provides examples of some major unresolved clinical problems encountered in daily cardiovascular practice as we care for elderly patients. Next, the authors summarize the current understanding of the mechanisms implicated in cardiovascular aging, and the potential for targeting novel pathways implicated in endothelial dysfunction, mitochondrial oxidative stress, chromatin remodeling, and genomic instability. Lastly, the authors consider critical aspects of vascular repair, including autologous transplantation of bone marrow-derived stem cells in elderly patients.